Wednesday, November 3, 2010

Actos and Avandia vs. Dikanut: Treatments for Diabetes that Work in Entirely Different Ways

If you have had type 2 diabetes very long, there is a high probability that your doctor gave you a prescription for either Actos or Avandia. These medications were briefly considered wonder drugs, lowering blood sugars effortlessly even when diabetics failed to stick to their diets.

Of course, if you have been following the news, you also know that an earlier drug in this class, Rezulin, had to be pulled from the market when hundreds of people died from liver failure, and that Avandia now comes with a black warning label. The same sage experts that told us Actos and Avandia were OK are slow to condone the use of the herb dikanut, also known as Irvingia gabonensis or inland mango, but one thing scientists know is that the herb acts in the opposite way from these common but dangerous diabetes medications.

The two diabetes drugs worked by activating a gene called PPAR-gamma. At first scientists thought that this gene worked to lower blood sugars by making insulin work better. Then they learned that the real effect had to do with transforming stem cells that were meant to replenish the bloodstream and to repair bone into fat cells. The newly engineered baby fat cells greedily soaked up sugar, and diabetics had lower blood glucose levels while they mysteriously got fat. Also, type 2's taking these medications had more broken bones, and, because of the way insulin works, more sodium inside the cells of their heart and muscles. Most type 2's on these medications gained weight--up to 100 pounds (45 kilos) in some cases--and many developed congestive heart failure.

This effect of the diabetes drugs on the gene is a phenomenon known as "up regulation." Scientists have noticed that dikanut works through "down regulation."

Dikanut actually makes it less likely that a stem cell generated in your bone marrow will become a fat cell. At the same time, however, as we discussed in an earlier article, it makes it more likely that the enzymes that (1) take sugar in from the bloodstream and (2) keep sodium from building up in the cell work very well. It helps people lose weight, and it helps diabetics normalize sugar levels, too.

It turns out that this is not the herb does. It also down regulates the herb that controls the making of the hormone leptin. If you can't keep these hormones straight, don't worry about it. Sometimes we have to stop and think, too.

Leptin is the hormone that sends a message to the brain from the fat cells that essentially says "OK, enough already." That would seem to be a good thing, except when you have a lot of fat cells, the message turns into "STOP! NO MORE FOOD!" and the brain, ironically, ignores it. Dikanut "turns down the volume" so the brain pays attention when it gets the signal to stop eating.

Dikanut also up regulates the gene that controls the manufacture of adiponectin. This hormone also tells the brain it's OK not to eat, but when people get fatter, the fat cells make less of it. Dikanut restores normal amounts of adiponectin production, which make it easier not to eat. For leptin, it helps the brain "pay attention" to the message. For adiponectin, it turns up the volume.

No herb is a cure all. No herb really works without diet. Some herbs have side effects, and, actually, this herb does, too. Some people who use get gas. If you try it, make sure you have minimal social obligations during the first day of use. But this is one herb that may make a real difference in your diabetes routine, as long as you remember that the proof of how well any remedy for diabetes works is in the testing. Take your blood sugar levels to know for sure that what you are doing for your type 2 diabetes actually works.

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